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Angioedema is swelling that happens just below the surface of the skin, most often around the lips and eyes. When you have an allergic reaction, your body produces histamine, which causes blood vessels to swell. Angioedema is like hives, but with hives there are itchy red welts on the surface of your skin. Angioedema is a deeper swelling.
Both hives and angioedema are usually caused by an allergic reaction, to either a food or medication. Things like pollen or insect stings can also cause angioedema. In rare cases, it may be a sign of an underlying condition, such as leukemia or Hodgkin's disease. There are two basic types of angioedema:
Angioedema can take anywhere from minutes to hours to develop. It may affect just one side of the body but not the other. In most cases, angioedema is mild. Severe angioedema can cause the throat or tongue to swell, cutting off the airway, and it can be life threatening.
Signs and Symptoms
Common symptoms of angioedema include:
What Causes It?
Sometimes the cause is unknown. Angioedema may be caused by allergies to foods, dyes, or pollen, or certain medications. Foods that often cause allergies include shellfish, dairy, and nuts. Drugs that often spark allergic reactions include nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or Advil), blood pressure medications, aspirin, and antibiotics. Conditions such as leukemia, Hodgkin's disease, and connective tissue disorders such as lupus may also trigger angioedema.
Who's Most At Risk?
These factors increase the risk for angioedema:
What to Expect at Your Provider's Office
Your health care provider will do a physical exam and ask about your symptoms. Be sure to tell your health care provider about all medications -- prescription and over-the-counter -- as well as herbs and supplements you are taking. Blood and urine tests may help pinpoint the cause of the angioedema.
You should get rid of any known or suspected triggers for allergies. Allergy testing with a trained specialist may help identify what you're allergic to. If you often have angioedema, you should wear a Medic Alert bracelet.
If you have mild angioedema, you may be able to treat it with over-the-counter antihistamines or alternative therapies. With severe angioedema, the first priority is to ensure that the person’s airway is open and they can breathe. The next steps include finding and removing the allergen as well as relieving other symptoms. You can manage infrequent attacks as they happen. Frequent attacks may require ongoing treatment, perhaps with an allergist, dermatologist, or other specialist.
Several medicines may help prevent or relieve attacks. For mild cases, you can use over-the-counter antihistamines, such as Benadryl, Zyrtec, Allegra, or Claritin. Note that Benadryl often causes drowsiness.
Your doctor may prescribe antihistamines. Mild attacks tend to clear up within 4 days with or without medication. For severe cases, your doctor may prescribe corticosteroids to reduce swelling and itching, or you may need a shot of epinephrine (EpiPen).
Complementary and Alternative Therapies
In a severe attack, you should seek emergency help right away. Do not take any new drugs, herbs, or supplements during an attack.
Following a good nutritional plan and using some herbs in between attacks may help reduce or prevent angioedema. Herbs and supplements may help reduce mild symptoms, especially if you often have angioedema. Find a health care practitioner who is experienced at prescribing herbs and supplements so you can find the right ones for you. It is important to tell your doctor about all medications, herbs, and supplements you are taking.
Nutrition and Supplements
Some foods may trigger angioedema in people who are allergic. You should eliminate any foods or food additives that trigger symptoms. The following are the most common food triggers:
Some people may have a reaction in response to:
Your health care provider can help identify food triggers by:
If you have stomach symptoms such as abdominal pain, vomiting, diarrhea, or reduced appetite, you may want to try a diet that eliminates common food triggers even if you don't have a specific food allergy.
These supplements may also help treat symptoms:
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, take herbs with care, under the supervision of a health care provider.
Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
Some doctors report that acupuncture may help reduce the frequency or severity of allergic reactions such as angioedema.
Prognosis and Possible Complications
If angioedema affects the throat, the person’s airway could be blocked, which could be life-threatening. In rare cases, angioedema may develop into anaphylaxis, which requires emergency medical care to maintain breathing, blood pressure, and heart function and to reverse the reaction.
After an attack, it's important to identify and avoid any triggers and to treat any underlying condition.
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Review Date: 6/26/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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